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Clinical experience of switching to atazanavir in the UK’s largest clinic


Although atazanavir received approval in the US for treatment of both naïve and experienced patients, approval in Europe was for treatment-experienced patients only. Nevertheless many clinics are using ritonavir-boosted atazanavir as first-line treatment, and as preferntial choice for switching patinets intollerant to efavirenz. Atazanavir requires once-daily dosing, has a low pill count and has good reported tolerability.

Holmes and colleagues from the Chelsea and Westminster Hospital, the UK’s largest clinic, presented results from a prospective review of 241 patients who switched to atazanavir during the last 12 months (all but ten using ritonavir boosting). 89/241 patients were PI-naïve, 47 were single-PI experieced and 105 were multiple PI-experienced. Reasons for switching included adverse drug reaction (78), end of trial (28) and adherence (9).

At week 48, by intent-to-treat analysis 60% and 57% of PI-naïve and PI-experienced patients respectively achieved viral suppression <50 copies/mL, (72% and 64% were <500 copies/mL). Patients changing due to virological failure had a mean viral load decrease of –2.1 and –1.9 logs in the naïve and experienced groups respectively. Rate of hypecholesterolaemia (>6.5mmol/L) dropped form 15% to 9% of patients. Mean bilirubin increase was 24 mmol/L with four patients discontinuing atazanavir due to jaundice.

Ref: Holmes PM, Tung M, Bower M et al. Atazanavir: 12 months of clinical experience in 241 individuals. 10th EACS, Dublin 2005. Abstract PE7.9/9.


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Information in this article was accurate in January 10, 2006. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.